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General NPI Number Information
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NPI Number | 1447073911
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Entity Type | Individual
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Provider Name | AMAYA GRANADO RBT
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Gender | Female
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 9107 W 6TH AVE SUITE 600
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City | LAKEWOOD
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State | CO
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Zip | 80215
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Country | US
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Telephone | 720-640-8322
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Fax |
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Provider Business Mailing Address
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Address Line | 12201 W 2ND PL APT 3207
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City | LAKEWOOD
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State | CO
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Zip | 80228-1558
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Country | US
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Telephone | 432-557-7257
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 246572683229
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License Number State | CO
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